The value of detecting pepsinogen and gastrin-17 levels in serum for pre-cancerous lesion screening in gastric cancer

Abstract

The aim of the study was to estimate the value of detecting pepsinogen (PG) I, PGII and gastrin-17 (G-17) levels in serum for chronic atrophic gastritis (CAG) screening and to determine the clinical applicability of combined measurement of serum G-17, pepsinogens (PGI, PGII) and PGI/PGII ratio (PGR) as a screening test for CAG. The PGI, PGII and G-17 levels were detected by ELISA in 68 patients with CAG and 86 healthy volunteers who underwent gastroscopy for gastroduodenal diseases at Taizhou Municipal Hospital between January 2016 and December 2016. Concentrations of all measured serum markers were lower in patients with CAG in comparison to healthy volunteers and achieved statistical significance (p<0.01) in PGI (93.25 vs. 126.98) and PGR (12.67 vs. 17.09). Receiver operating characteristic (ROC) curve analysis revealed the optimal cutoff values for PGI, PGII, PGR and G-17 at 98.10 μg/l, 6.92 ng/l, 15.77 and 1.94 pmol/l, with sensitivities of 72.10%, 58.10%, 61.60% and 59.30%, and specificities of 61.8%, 51.50%, 77.90% and 55.90%, respectively. The areas under the curve (AUCs) of PGI, PGR and G-17 were 0.728, 0.726 and 0.556, respectively. The increase of AUC was observed only in PGR and G-17 combination (0.741) with increased sensitivity (69.10% vs. 61.60%) of screening for CAG, whereas the specificity was reduced (72.10% vs. 77.90%) in comparison to PGR alone. Combination of serum indicators can raise the diagnostic accuracy of CAG in some respects. However, further research including a larger sample size is necessary in order to accurately determine the sensitivity and specificity of combined detection of serum indicators.

Comparison of Three Prediction Rules for Assessing the Risk of Gastric Cancer in Chinese Health Examination Populations

“…Moreover, the speci city was signi cantly lower than that of the Scoring System from JPHC (p < 0.001) and Li's Scoring System (p < 0.001). Consistent with previous research, the ABC method for gastric cancer screening did not work well in the Chinese populations, with lower sensitivity and speci city than those in nonChinese studies [23][24]. This may be related to the fact that the ABC method was developed in Japanese populations, and the optimal PG and G-17 cut-off values may not be applicable to screening for gastric cancer in China.…”

Prevalence of atrophic gastritis in southwest China and predictive strength of serum gastrin-17: A cross-sectional study (SIGES)

“…Among the family of gastrin, G-17 particularly plays a critical role in the regulation of gastric acid secretion 43 . Some other researches similarly found high level of serum gastrin was associated with precancerous lesions and gastric cancer in Asians [44][45][46][47] . The results of the present study demonstrated that the prevalence of atrophic gastritis tended to increase from benign to malignant lesion.…”

Gastrin-17 Combined With CEA, CA12-5 and CA19-9 Improves the Sensitivity For the Diagnosis of Gastric Cancer

“…However, recent studies found that gastrin was closely associated with GC and precancerous lesions [13,[25][26][27]. Moreover, Yu et al found that serum gastrin level could be used for screening pre-cancerous lesion in gastric cancer [28]. These suggested the possible role of gastrin in the diagnosis of GC.…”

“…Elevated serum gastrin is caused by lots of conditions, including GC [11], suggesting gastrin can be used as a potential marker for the diagnosis of GC. Recently, some researchers evaluated the value of detecting gastrin-17 levels in serum for precancerous lesion screening in GC, but reports on assessing the effect of gastrin in the diagnosis of GC were very few [12][13]. Therefore, the effect of gastrin in the diagnosis of GC should be clari ed further.…”